From The Editor | July 27, 2011

HIT Must 'Go Rural'

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By Ken Congdon, editor in chief, Health IT Outcomes

Consider the following:

  • 50 million Americans live in rural areas.
  • There are only 65 primary care physicians per 100,000 rural Americans — approximately 40 less than the 105 per 100,000 urban or suburban Americans.
  • Rural areas have less than half the number of surgeons and other specialists than urban and suburban areas.
  • In 70% of rural markets quality of care was measurably worse than in urban areas.
  • Rural Americans are more likely to suffer from chronic health conditions such as diabetes, heart disease, and cancer.
  • More than half of rural Americans must travel more than 20 miles for specialty care, with an average reported distance of 60 miles.

 

These and other statistics referenced in a recent report by UnitedHealth Group and Harris Interactive titled Modernizing Rural Health Care: Coverage, Quality, and Innovation illustrate the healthcare challenges facing today’s rural communities. And according to the study, these conditions will only get worse if appropriate action is not taken. For example, under healthcare reform, a projected 8 million additional rural residents will join Medicaid or other state- and government-subsidized insurance plans by 2019, placing even greater pressure on the provider community in those areas.

EHRs and Telemedicine Key To Rural Health Transformation

What’s the answer to accommodating rural patient growth and improving the overall quality of rural patient care? Well, it all begins with multidisciplinary teamwork in rural primary care and greater provider collaboration between rural and urban care systems. Instrumental in these and other initiatives will be health IT. For example, rural uptake of EHR and HIE technology will allow for the seamless exchange of patient data between rural and urban healthcare facilities, and specialists and primary care physicians. Patient portal technology and PHRs (personal health records) will allow rural patients to become more engaged in improving and managing their own health. However, telemedicine and telehealth technologies offer, arguably, the greatest potential to transform rural healthcare — improving the accessibility, quality, and affordability of care.

For example, with teleconferencing technologies, a rural patient can be seen by an urban specialist without either party ever leaving their own backyard. Remote patient monitors and other devices can provide physicians with real-time visibility into patient conditions without ever requiring the patient to come in for an office visit. These technologies can be vital to streamlining and improving chronic care management. However, to make full use of telemedicine’s potential, a number of changes to the current healthcare system and technology grid will be required. These include:

  • Expanding rural broadband capacity (estimated at approximately 60% in rural areas as opposed to 70% in urban areas).
  • Improving public and private reimbursement models for telemedicine technologies and provider/patient interactions.
  • The removal of outdated regulatory barriers to telemedicine adoption.

 

The above changes must be a priority to ensure the delivery of quality care to rural Americans in the reform era.

Telehealth Adoption Picks Up Steam

Have a comment or feedback for Ken on this article? He can be reached directly at ken.congdon@jamesonpublishing.com.